When Ebola Comes to Your City

One thing that's more contagious than Ebola: fear.

Update, Oct. 8: Thomas Eric Duncan, the first patient to be diagnosed with Ebola in the U.S., died today.

DALLAS—Lots of people here are playing a mental game against themselves. Let's call it the Ebola Odds. I played the game myself this weekend as I strolled through the Texas State Fair.

At one point, walking past a pen of baby goats in a livestock display, my forearm pressed against someone's bare arm as they passed by. Skin-on-skin contact! Inwardly, I recoiled, and started to calculate the odds. An overnight rain tamped down the Dallas heat, meaning fewer people perspiring, meaning the stranger's sweat didn't get on my arm. Points in my favor. Plus, the passer-by was actually at the State Fair and probably not feeling the symptoms of Ebola—abdominal pain, vomiting, and fever. And the process of identifying and isolating people who were in contact with the known carrier—called a contact trace—is under way and, despite some embarrassing stumbles, moving forward. That helps, too.

Within seconds I calculated my odds, giving myself 99.8 percent chance that I did not, in fact contract Ebola the Texas State Fair. But that 0.2 percent. That's where the fear lives.

Just a few weeks ago, my chances of contracting Ebola in the Lone Star State stood as close as you could possibly get to a stone cold zero-point-zero. But the world's most feared infectious disease is here in Dallas: Last week, a man who flew here from Liberia became the first patient to be diagnosed with Ebola at a U.S. hospital, sending public health officials on a frantic search for anybody he was in contact with before showing symptoms. And that reality stirs up emotions.

Marquee Dread

On a weekly basis, I receive a press notice from the Centers for Disease Control and Prevention called the Morbidity and Mortality Weekly Report. It is unsettling. "On September 16, 2014, CDC was notified by the Colorado Department of Public Health and Environment of a cluster of nine children evaluated at Children's Hospital Colorado with acute neurologic illness characterized by extremity weakness, cranial nerve dysfunction, or both," one recent MMWR said. The cause of this Colorado outbreak? "Of unknown etiology."

The United States is beset by all sorts of nasties. Take the rise of Methicillin-resistant Staphylococcus aureus (MRSA) a potentially deadly superbug that has evolved to survive exposure to antibiotics. The CDC says 75,309 cases of the untreatable infection have swept through hospitals, preying on weakened victims. There is a host of bugs and illnesses in the United States that a person could catch—ones that are more mysterious, common, and communicable than Ebola.

Part of it is celebrity. Like most people, I was exposed to the existence of Ebola by reading The Hot Zone by Richard Preston. The first section of the book describes the last stage of the disease—a bloody progression of organ liquefaction and elimination. Ebola was a great villain, a monster that appears out of nowhere and leads a village to ruin.

The numbers on Ebola are terrifying, too. It has a mortality rate of 70 percent, to start with. What you should know, however, is that the mortality rate actually swings from 20 percent to 90 percent based on the quality of care and treatment a patient receives. America has some of the most robust infectious disease control measures around, especially when you're talking about an outbreak like Ebola that is not airborne.

And the images of the outbreak contribute to the anxiety. The sight of doctors and nurses in full body suits and respirators can't help but summon visions of Steven King-scripted airborne superflu. But the truth is that these measures represent an abundance of caution. The CDC recommends healthcare providers entering an Ebola patient's room should wear gloves, a gown, a face shield, and a mask. Doctors and nurses in rural Africa do not have the medical backup of a modern hospital and have higher risks while working among the infected and the dead for hours on end. A full suit makes sense in those conditions, even if the optics add to the fear.

The fear of Ebola is real. But the situation in Dallas is not the same as the situation in rural Africa. This does not make the need to fight the outbreak in Africa any less pressing, or the quarantine in Dallas any less vital. But it should tamp down the dread in Texas.

Big Tex, Big Fear?

Outwardly, Dallas seems calm. The Texas State Fair was packed with people this weekend. They milled around in throngs, waited in lines together, and packed shoulder-to-shoulder to watch pig racing and square-dancing. I didn't hear too much talk about Ebola, just an occasional reference in passing, and that was usually a joke.

Still, there were extra stands of hand sanitizers set up all over the venue. Even the iconic, 55-ft-tall statue Big Tex was reprogrammed to say something about it. "Remember always wash your hands before eating," he advised fairgoers solemnly.

It's sage advice no matter what the circumstance. But it's telling that even Big Tex has Ebola in the back of his mind.

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